Provider Demographics
NPI:1699116947
Name:FELDMAN, NATHANIEL JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:JOHN
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3324 ORION DR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4378
Mailing Address - Country:US
Mailing Address - Phone:515-232-2007
Mailing Address - Fax:
Practice Address - Street 1:3324 ORION DR
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4378
Practice Address - Country:US
Practice Address - Phone:515-232-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09022122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist